Perioperative myocardial injury (PMI) secondary to ischemia/reperfusion (I/R) remains a major cause of cardiovascular morbidity and mortality following cardiac surgery and transplantation, and is further exacerbated by acute hyperglycemia. Hyperglycemic exacerbation of PMI significantly blocks the cardioprotective effect afforded by glucose-insulin-potassium (GIK). To date, there is not an effective treatment or prevention of perioperative myocardial injury due to ischemia/reperfusion.
Annexin A1 (ANXA1), a 37 kDa protein, is a member of the annexin superfamily, which consists of 13 calcium and phospholipid binding proteins with a significant degree of biological and structural homology (40-60%). ANXA1, originally identified as a mediator of the anti-inflammatory effects of glucocorticoids, has diverse biological functions including the regulation of inflammatory pathways, cell proliferation machinery, cell death signaling, and the process of carcinogenesis. Altering the expression or the localization of this protein can contribute to the pathogenesis of human diseases including inflammatory diseases, cardiovascular diseases and cancer. It has been demonstrated that ANXA1 reduces the leukocyte-dependent myocardial damage associated with myocardial I/R injury (La et al. (2001) FASEB J. 15(12):2247-2256). The functional link between migrated leukocytes and the myocardial damage was confirmed, and significantly lower numbers of extravasated leukocytes were counted in the group of rats treated with ANXA1 (La, M. et al. supra).
Pharmacological analysis has also demonstrated that the first 25 amino acids of the N-terminus of ANXA1 (termed Ac2-26) is the active region of biological function and can reproduce the anti-inflammatory actions of the full-length protein. Ac2-26 protects against splanchnic artery occlusion and reperfusion injury by affecting neutrophil migration and against experimental myocardial ischemia-reperfusion by attenuating neutrophil migration (Gasterdelo et al. (2009) Am. J. Pathol. 174(1):177-183).
Therefore, it is an object of the present invention to provide new compositions comprising ANXA1, and methods of using such compositions, to address this unmet need.